Post-op diet - not enough calories?

[Susanne 32]

I am feeling so great, but I seem to hit the ceiling every time I want to do something - even just going to the store - because I am getting tired. I feel it is because of the low amount of calories I get. My post-op diet is all Protein supplements which include 70 calories (fruit drink), 80 calories (beef broth, Tomato bouillon), 80 calories (Cappuccino, hot cocoa, mocha), 100 calories (berry protein shake).

So I get 4 a day from this selection, which usually leaves me at 330 calories. I then have a bottle of coconut Water (60 calories) and regular water (0 of course) so I generally stay in the 400 calorie range with 60g of protein.

This is crazy and it also goes against anything I have ever heard about diets. I know they are trying to be really pushing the post-op weight loss but this seems insane. Over the last years, I kept hearing that too low a calorie goal is causing starvation mode and shutting down my metabolism and what not.

When I called my NUT and asked about the coconut water she said I'd better take a supplement to avoid calories. Really? 60 calories for a bottle of coconut water seemed like an issue?

Does anyone have an idea about this? It is not that I am particularly hungry - even though the food starts to bore me to death - but I am starting to worry that this small amount of calories actually hampers by success?

Susanne

[NinaX 6]

I am feeling so great, but I seem to hit the ceiling every time I want to do something - even just going to the store - because I am getting tired. I feel it is because of the low amount of calories I get. My post-op diet is all Protein supplements which include 70 calories (fruit drink), 80 calories (beef broth, Tomato bouillon), 80 calories (cappuccino, hot cocoa, mocha), 100 calories (berry Protein shake).

So I get 4 a day from this selection, which usually leaves me at 330 calories. I then have a bottle of coconut Water (60 calories) and regular Water (0 of course) so I generally stay in the 400 calorie range with 60g of protein.

This is crazy and it also goes against anything I have ever heard about diets. I know they are trying to be really pushing the post-op weight loss but this seems insane. Over the last years, I kept hearing that too low a calorie goal is causing starvation mode and shutting down my metabolism and what not.

When I called my NUT and asked about the coconut water she said I'd better take a supplement to avoid calories. Really? 60 calories for a bottle of coconut water seemed like an issue?

Does anyone have an idea about this? It is not that I am particularly hungry - even though the food starts to bore me to death - but I am starting to worry that this small amount of calories actually hampers by success?

Susanne

I've said before on this forum and I'll say it again (and you are saying it yourself aswell); you are putting your body in starvation mode on that amount of calories. That any serious nutritionist can recommend that sort of diet after weight surgery is beyond me. Why? The size of your new stomach will do enough restriction without having to count calories at all. Unless you use the meals to eat icecream, crisps, burgers ans sweets - you WILL loose the weight without silly calorie counting! Assuming you eat sensible food with focus on Proteins, the weight will come off.

A normal person uses 1,2 calories per minute while sleeping, so 72 cals per hour, do the math for an 8 hour night. To get out of bed, keep your heart beating and your brain working your body required a minimum of approx 450-500 cals/day. Of course being overweight your body will have some reserves, but on starvation mode it will hold on to every fat cell there is; that is a survival mechanism for the body.

I'm sorry if I get all worked up here, but I would love for everybody to have the same experience as I have, with a nutritionist who was very clear; NO MORE DIETS, NO MORE CALORIECOUNTING! EVER! Just really good, tasty, sensible food of good quality, with mostly Proteins and obeying to the amount restrictions given by the stomach size! The weight that was lifted off my shoulders when she said that was bigger than the overweight I carry on my body!

The diet you are describing sounds like a pre-op diet here in Sweden, where those with BMI +40 have to decrease the fat around the liver quickly. But even then they will be on around 800 cals.

So if I were you I would question my nutritionst and defintely increase the daily intake. Best wishes and good luck!

[MuffinsMom 5]

Right now, at about 9 days out, and restricted to liquids, it would be difficult to get more calories in anyway. Your body should be OK for a little while at this calorie level. The starvation reaction sets in after several weeks of severe calorie restriction, but by then you will probably be up quite a bit. Many successful post-ops report that they maintain a calorie level of 600-900 (depending on what works for their bodies) thru their weight-loss phase. At 13 weeks out, or thereabouts, I'm at about 700-900 calories a day, which helps me feel healthy and energized but keeps the weight coming off.

Also, you just had major surgery! You may also still be feeling the effects of anesthesia, which can take up to a month to wear off, surprisingly. Also healing from the surgery uses quite a bit of energy, which will also make you feel tired early out. I'd say relax and go with it. Don't try to do all the things you did pre-op, give yourself time to recover from the surgery itself, rest as much as you can - I know work and family sometimes get in the way, LOL! After you're 4-6 weeks out, reassess your energy level and feeling of general health and discuss with your nut then.

[NinaX 6]

I am feeling so great, but I seem to hit the ceiling every time I want to do something - even just going to the store - because I am getting tired. I feel it is because of the low amount of calories I get. My post-op diet is all Protein supplements which include 70 calories (fruit drink), 80 calories (beef broth, Tomato bouillon), 80 calories (cappuccino, hot cocoa, mocha), 100 calories (berry Protein shake).

So I get 4 a day from this selection, which usually leaves me at 330 calories. I then have a bottle of coconut Water (60 calories) and regular Water (0 of course) so I generally stay in the 400 calorie range with 60g of protein.

This is crazy and it also goes against anything I have ever heard about diets. I know they are trying to be really pushing the post-op weight loss but this seems insane. Over the last years, I kept hearing that too low a calorie goal is causing starvation mode and shutting down my metabolism and what not.

When I called my NUT and asked about the coconut water she said I'd better take a supplement to avoid calories. Really? 60 calories for a bottle of coconut water seemed like an issue?

Does anyone have an idea about this? It is not that I am particularly hungry - even though the food starts to bore me to death - but I am starting to worry that this small amount of calories actually hampers by success?

Susanne

Hi again,

Just now saw that you had your surgery the day after me (I was sleeved 1st Nov) and still in liquids. So, take it easy and rest of course but my advice would still be to increase your Protein drinks to feel better and to heal quicker.

I moved from fluids to puré food on tuesday this week, and just getting more calories and more nutrion in has made the world of difference!

Feel good!

[Tiffykins 672]

That is super low, and even at 600-800 calories a day some VSG'ers go into starvation mode. That low amount of calories is super restrictive, and pretty absurd. I'm all about following "guidelines" for safety reasons post-op, but to only be consuming 300 calories a day is way too low in my opinion. When I had trouble getting in calories early out, my nutritionist suggested 100% fruit juice and regular gatorade. Starvation mode has also been debated for years on what it does to our metabolism.

I stuck to 600-800 calories a day, and did great losing weight, but the first few weeks into the post-op diet did leave exhausted and pretty much fatigued. I don't think I could function on 300 calories a day. As for "dieting", I never really considered the post-op dietary guidelines a "diet". Eating whatever I wanted, not tracking my intake got me to 270lbs so I decided to follow the guidelines and tweak what I could for my own personal needs/wants.

[mysparky 1]

Susanne -

My NUT gave me Protein and Fluid goals, but nothing specific in terms of calories. She acknowledged that the calories are quite low and if I was able tolerate it and felt like I needed it, I could drink more of my Protein shake. Many people have trouble getting the Protein down in those first few days, but I definitely didn't.

Originally I was told to drink 6-8oz Protein Shake (which would equate to 260-280cals) and I upped that to 10-12oz. That moved my calorie count up to the 400-520 range and protein-wise, I was drinking close to 50gr of protein. Some days I drank less, other days I drank more. I'll tell you, that made a big difference in my energy level. This was key for me because I went back to work 9 days post-op and needed to get through the day.

Sounds to me like you could use a bump up!

[mastadonn 0]

My Doctors and nutritionist have widely varying ideas on how much to take in.

The nutritionist's program guidelines say at least 1200 calories per day, 100-140 gr. Protein, at least 130 grs of carbs and no less that 30 grs of fat. She believes that less than that will put my body into starvation mode and be counterproductive.

The Doctors (surgeon and primary care) say around 800 calories per day is ok with 80-100 gr of Protein, low carb and fat. When I asked the surgeon about the diference of opinion this week, he said that your body is supposed to be in starvation mode following the surgery. I think he was joking?

I had surgery on 10/19 and just started soft foods this week. In general I have been in the 600-800 cal range over the past two weeks and don't see how I would be able to get in 1200 calories per day.

While Breakfast cereals like oatmeal or cream of wheat have a good amount of carbs (20 gr. or so), everything else I am eating combined throughout the day probably does not add up to more than 40 gr total.

Essentially, I eat until I fill full and then stop. This usually amount to 3-4 oz, even though my program guidelines say I could eat up to 6 oz at a time, during the 4-6 month soft food stage.

10/19/10

392/365/343

[mp8btpc 32]

I agree with all above posters, the first couple weeks I maybe got 400 calories but that was because I was not feeling the shakes etc and I just wasn't able to get much down but as soon as I could move on to pureed/soft foods I was able to start getting more. Then when I reached the "normal" foods area I was tracking my foods and trying to stay around 800 or so and now I get around 800-1000 depending on the day. I don't track it I can sort of do it all in my head and I know when I have eaten too many calories (THANK YOU HALLOWEEN candy lol) but there is no way I would stick with a 600 calorie diet for any amount of time. It is counter productive and unnecessary IMO, we need to feed it with good foods but lets not starve it.

I like the thought that I am not really "dieting" I am just eating healthier and eating small portions. It is wonderful.

Also I was exhausted post op and depressed. As someone mentioned above it happens a lot with anesthesia plus add on top of it the calorie restriction we have forced on our bodies suddenly.

Hope you feel more energy soon!

[GayleSBennett 0]

When I was on a liquid diet I was able to have Jello. Can you eat jello to up your calories a bit?

[PamelaAM 16]

During the first 10 days after surgery, I was having a hard time getting much in the way of calories down while on liquids. And my surgeon said if I got 45 grams of Protein in he was fine with that. Well when I went in on day 11 for my post op I couldn't even walk I was so weak. My doctor told me my body was in starvation mode and that I needed carbs right away. My brain was so foggy I couldn't hardly think. In fact, I fell when I had to go into the restroom at the doctor's office. The doctor told me that my body was not able to survive without carbs like some people can and instructed me to go down the street to Del Taco and eat some refried Beans and then to go home and eat ice cream. He made a specific point of saying "not lowfat and not sugarless, get the full on regular ice cream". I ate that for 3 days and what a world of difference it made!

I'm not saying that anyone else should indulge in ice cream but what I am saying is that you should take to your doctor and they may need to make some adjustments to your diet. Every person's body and biochemistry is different and I don't believe there is a one size fits all solution with this surgery.

[Susanne 32]

Thanks a lot for the spirited discussion - this seems to be an issue for many.

First, a little misunderstanding - they didn't tell me to follow a < 400 cal diet. It just comes out like that with the supplements I picked. I am not sure, maybe there were some with more calories and I just happened to pick the lo cal options (and seriously, that would be the first time, LOL)

My real goals are 64 oz. of water/beverages and 60 g of Protein - and I don't have a problem with either goal. These supplements are the ones I have to use in the first two weeks after surgery for the healing period. And the healing aspect is the only reason why I am not straying away right now. I once had a wisedom tooth poking through my gums leaving a very small hole which happened to catch a little bit of food and leaving me with a bad infection. I envision a similar scenario for my stomach staple line if I eat anything but my shakes and broths.

I played phone tag with my NUT today which was really annoying and I sent her an email now asking for advise. I am not sure what she'll say, I wasn't very happy with the last few times where she advised me to use a potassium supplement instead of drinking natural coconut Water becasue of the calories (Zico coconut Water has 60 calories for a bottle). I thought that was absolutely ridiculous.

My follow up appointment is on 11/18 and my 2 weeks post-op are over on the 15th but I am at a point right now where I am looking at the damn supplements and rather eat nothing than that stuff because I just can't stand it anymore. From what I understand, other people start full liquids already during the second week - is my surgeon overly cautious? I had bought a few Soups before surgery, these http://www.pacificfoods.com/our-foods/carton-soups (Chipotle Sweet Potato, Roasted Garlic Mushroom Lentil, Poblano Pepper with Corn) I was wondering if I could blend and eat them? How about some yogurt? I could mix some Greek yogurt with herbs and spices as a heart option? How about mashed potatoes - thinned with more milk than normal maybe?

I am just a few days away from "full liquids" I need some hearty flavor or I'll go absolutely crazy!!!

[Susanne 32]

Clarification on "Full Liquid" - I just googled this and found this link:

http://www.livestrong.com/article/213702-bariatric-full-liquid-diet/

Does that agree with what everyone considers a full liquid diet? Again, my surgery was on 11/2 and I am still on more or less clear liquid diet

[Susanne 32]

OK, I just got an email back from my NUT and she sent me the plan for week 2 to 4:

http://www.bananatummy.com/2010/11/food-for-week-2-4/

I am so excited - and no calorie limit (not that I'll won't be careful)

[BlackBerryJuice 349]

330 calories a day....pretty sure a newborn requires more than that! At first, I ate about 600-800. After about a month, once the swelling subsided and my stomach increased in size a bit, I started eating more. These days, I'm usually at about 1100-1200, with the range being between 1000 and 1400. I work out pretty hard about 5 times a week. It's worked well for me so far, but if you are entirely sedentary, 1400 might be getting a little too high. These extreme starvation diets just make you lose muscle mass, there's SO MUCH research on it out there, I don't understand why ANY health practitioner would recommend that someone eat that little! Less muscle mass equals slower metabolism (i.e. less weight loss later on) and looking like a melted snowman after you've lost weight, because most of that weight was muscle - which is what makes you look firm and shapely.

[M2G 1,836]

My NUT actually said don't worry about calorie counting at this point (I'm 3 weeks out) but they really just stress getting in the right amount of Protein 65-80 grams is perfect. I did notice when I started logging my food, that my calorie intake was usually about 500-600. I have had a couple of days where I ventured into the 700 calorie range, but usually is still between 500-600. And yes, I have had those lethargic days where I just have zero energy.

Are you hitting your Protein goals? That has been stressed over and over to me by my NUT.

You are also very newly sleeved...I didn't even track what I was eating until I was on mushie foods and the reason for tracking was to keep track of my protein intake. I'm sure it will be bumping up soon as you add in new foods.